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White collar crimes: Indictments in $1.4B hospital testing fraud

On Behalf of | Jul 6, 2020 | White Collar Crimes |

Allegations of the fraudulent billing of $1.4 billion for medical tests recently resulted in the indictment of 10 people. Michigan residents who follow white collar crimes cases might be interested to learn more about this case. According to the charges, 10 people were accused of conspiring in a scheme to bill private health insurers for fraudulent laboratory tests.

The alleged fraud took place between 2015 and 2018. It all purportedly started with the accused individuals, ages ranging from 44 to 60, identifying financially struggling small hospitals in rural areas of various states. The defendants allegedly bought the facilities through multiple management companies and then used them to bill insurers for fraudulent urinalysis drug tests and blood tests.

The indictments assert that hospitals that do laboratory tests in their own labs can claim higher refunds than those sent for analysis by outside laboratories. The defendants allegedly had the lab tests done at off-site facilities controlled by them. However, investigators allege the accused conspired to bill private insurers as if the testing was done at the hospitals. The alleged total amount billed to insurers is approximately $1.4 billion, of which the health insurance companies paid roughly $400 million to the conspirators.

An indictment does not constitute guilt and these 10 defendants will remain innocent in the eyes of the law until and if the prosecution can prove their guilt beyond a reasonable doubt. Anyone in Michigan who is indicted for white collar crimes will likely require the services of legal counsel. An experienced criminal defense attorney can examine the charges and scrutinize the evidence before devising a strong defense in pursuit of the best possible outcome for the client.